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Medicaid managed-care oversight gap costing millions

Evidence is mounting that Medicaids rapid expansion under the Affordable Care Act has far outstripped the governments ability to monitor the taxpayer money it turns over to insurers.

By Chad Terhune, Kaiser Health News | Updated on February 22, 2018
Increasingly, states have embraced managed care in hopes of controlling Medicaid costs, but the contracts can be more beneficial to the companies executing the contracts. (Photo: Shutterstock)

CHULA VISTA, Calif. — Norma Diaz and her husband, Joseph Garcia, have dedicated their careers to running a nonprofit health insurer that covers some of California’s neediest residents.

For three decades, they have worked for a Medicaid managed-care plan, Community Health Group, serving nearly 300,000 poor and disabled patients in San Diego County under a state contract funded entirely by taxpayers. They’ve earned above-average ratings for patient care.

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